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Int J Surg. 2020 Mar 10. pii: S1743-9191(20)30210-7. doi: 10.1016/j.ijsu.2020.02.045. [Epub ahead of print]

Use of the eLogbook in surgical training in the United Kingdom: A nationwide survey and consensus recommendations from the Association of Surgeons in Training.

Author information

1
Association of Surgeons in Training, 35-43 Lincoln's Inn Fields, Holborn, London, WC2A 3PE, UK. Electronic address: beamishaj@gmail.com.
2
Association of Surgeons in Training, 35-43 Lincoln's Inn Fields, Holborn, London, WC2A 3PE, UK.
3
General and Colorectal Surgery, North East, UK. Electronic address: oroog.ali@gmail.com.
4
General Surgery, Yorkshire, UK. Electronic address: joshburke@doctors.org.uk.
5
Upper GI Surgery, Northern Ireland, UK. Electronic address: joshua.michael.clements@doctors.org.uk.
6
General and Colorectal Surgery, West midlands, UK. Electronic address: Vanessacubas@nhs.net.
7
General and Colorectal Surgery, Ireland. Electronic address: christina.fleming49@gmail.com.
8
Plastic Surgery, London, UK. Electronic address: Lolagiwa@doctors.org.uk.
9
General and Colorectal Surgery, West midlands, UK. Electronic address: j.glasbey@bham.ac.uk.
10
Plastic Surgery, London, UK. Electronic address: Vimal.gokani@gmail.com.
11
Trauma & Orthopaedics, Wales, UK. Electronic address: gianluca.gonz@gmail.com.
12
General Surgery, Wales, UK. Electronic address: Rhiannon.harries@doctors.org.uk.
13
Trauma & Orthopaedics, KSS, UK. Electronic address: katiephughes@gmail.com.
14
General and Endocrine Surgery, Merseyside, UK. Electronic address: lizikane@hotmail.co.uk.
15
Orthopaedics, SE, Scotland, UK. Electronic address: kemacleod@doctors.org.uk.
16
Renal Transplantation, London, UK. Electronic address: miriammanook@gmail.com.
17
General and Colorectal Surgery, Ireland. Electronic address: Helen.mohan@gmail.com.
18
General and Colorectal Surgery, Ireland. Electronic address: deirdrenally@rcsi.com.
19
General Surgery, Wessex, UK. Electronic address: p.pucher@imperial.ac.uk.
20
Colorectal Surgery, North-West Thames, UK. Electronic address: ks303@doctors.org.uk.
21
Otorhinolaryngology, SouthWest Severn, UK. Electronic address: Fenella.shelton@doctors.org.uk.
22
Neurosurgery, Merseyside, UK. Electronic address: Nishsri09@gmail.com.
23
Neurosurgery, North West, UK. Electronic address: matthew.stovell@doctors.org.uk.
24
General Surgery, KSS, UK. Electronic address: anthonythaventhiran@me.com.
25
Otorhinolaryngology, East Midlands, UK. Electronic address: drnathanrwalker@gmail.com.
26
General and Breast Surgery, Yorkshire, UK. Electronic address: Alexander.wilkins@nhs.net.

Abstract

INTRODUCTION:

Accurate recording of operative cases is essential during training to demonstrate experience. However, indicative numbers delineating minimum desirable experience may incentivise exaggeration or misrepresentation of experience. This study aimed to determine perceptions of real-world eLogbook use among UK surgeons in training.

MATERIAL AND METHODS:

An anonymous online questionnaire was disseminated electronically using a pre-planned yield-maximisation strategy, incorporating regional champions, email and social media. Evaluation employed mixed methods in a combined interpretation of quantitative and qualitative data from the questionnaire. Recommendations for development of the eLogbook were itemised from respondents' free text items and a modified Delphi process, conducted within the Council of the UK national trainee representative body, the Association of Surgeons in Training, determined the strength of each recommendation.

RESULTS:

Analysis included 906 complete responses from training-grade surgeons (34.8% female) from all UK recognised specialties and all grades of training. More than two-thirds (68.5%) believed that overstatement or misrepresentation of case involvement occurs. A fifth (20.8%) reported witnessing trainees logging cases they had not actually participated in and almost a third (32.7%) had witnessed overstatement, yet few (15.1%) had raised such an issue with a supervisor. Most (85.2%) respondents had few or no eLogbook entries validated. More than a quarter of respondents felt pressure to overstate their involvement in cases (28.6%) and the number recorded (28.1%). Almost a third (31.5%) felt the required case number for completion of training was not achievable. Female trainees were less likely to feel well supervised (p = 0.022) and to perceive targets for completion of training were achievable (p = 0.005). Thematic analysis identified four key themes to explain logbook misuse: Pressure to achieve training milestones; eLogbook functionality issues; training deficiencies and probity.

CONCLUSIONS:

Inaccurate operative recording was widely reported, primarily in response to perceived pressure to achieve targets for career progression. Operative logbooks may not be as accurate as intended. Consensus recommendations are made for improvement in the eLogbook and its use.

KEYWORDS:

Assessment; Logbook; Medical education; Surgery; Surgical training

PMID:
32169575
DOI:
10.1016/j.ijsu.2020.02.045

Conflict of interest statement

Declaration of competing interest The authors are all current or past committee members of the Association of Surgeons in Training, the UK's pan-specialty independent surgical trainee representative body.

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